Chen Z M, Mao J H, Du L Z, Tang Y M
Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.
Acta Paediatr. 2002;91(9):914-22. doi: 10.1080/080352502760272588.
To explore the relationship between cytokine responses and severity of respiratory syncytial virus (RSV) infection in infants.
Intracellular interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) expression in peripheral blood CD3+ and CD8+ lymphocytes was measured by four-colour flow cytometry. Serum IL-12, IL-4 and IFN-gamma levels were also determined by enzyme-linked immunosorbent assay.
The frequency of IL-4 and IFN-gamma expression in CD3+CD8- cells was the same in RSV-infected, non-RSV-infected and control infants and in those with RSV bronchiolitis or RSV pneumonia, indicating that no Th2 predominance exists in the acute phase of RSV infection and RSV bronchiolitis. Furthermore, RSV-infected infants had a more frequent IFN-gamma expression in CD3+CD8+ cells than controls, and they also showed a much lower serum IL-4/ IFN-gamma ratio because of decreased IL-4 and elevated IFN-gamma, the latter being most prominent in RSV bronchiolitis. The serum IL-12 level in RSV-infected infants was the same as in control infants, while those with non-RSV infections had a much higher level. Serum IL-12, IFN-gamma and frequency of IFN-gamma expression in CD3+CD8+ cells in mild RSV infection were much higher than in controls, while no difference existed between severe cases and controls.
Type 2 cytokine predominance was not found in the acute phase of RSV infection and RSV bronchiolitis, but both were accompanied by enhanced production of IFN-gamma and a much higher serum IFN-gamma level than in healthy controls, especially in those with RSV bronchiolitis, suggesting a role in causing airway obstruction. IFN-gamma and IL-12 may also play a protective role in RSV infections by diminishing viral replication, and high levels of IL-12 and IFN-gamma may be associated with lessening of the severity of infection.
探讨细胞因子反应与婴儿呼吸道合胞病毒（RSV）感染严重程度之间的关系。
采用四色流式细胞术检测外周血CD3 +和CD8 +淋巴细胞内白细胞介素-4（IL-4）和干扰素-γ（IFN-γ）的表达。同时采用酶联免疫吸附测定法测定血清IL-12、IL-4和IFN-γ水平。
RSV感染婴儿、非RSV感染婴儿及对照婴儿，以及患有RSV细支气管炎或RSV肺炎的婴儿中，CD3 + CD8 -细胞中IL-4和IFN-γ的表达频率相同，这表明在RSV感染和RSV细支气管炎的急性期不存在Th2优势。此外，RSV感染婴儿CD3 + CD8 +细胞中IFN-γ表达比对照婴儿更频繁，并且由于IL-4降低和IFN-γ升高，其血清IL-4/IFN-γ比值也低得多，后者在RSV细支气管炎中最为明显。RSV感染婴儿的血清IL-12水平与对照婴儿相同，而非RSV感染婴儿的血清IL-12水平则高得多。轻度RSV感染时血清IL-12、IFN-γ以及CD3 + CD8 +细胞中IFN-γ表达频率均显著高于对照婴儿，而重症病例与对照婴儿之间无差异。
在RSV感染和RSV细支气管炎的急性期未发现2型细胞因子优势，但二者均伴有IFN-γ产生增加以及血清IFN-γ水平显著高于健康对照婴儿，尤其是RSV细支气管炎婴儿，提示其在导致气道阻塞中发挥作用。IFN-γ和IL-12还可能通过减少病毒复制在RSV感染中发挥保护作用，而高水平的IL-12和IFN-γ可能与感染严重程度减轻有关。
